Kathleen M. Raviele, MD PC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

020801 Issued in GA

Legal business name

KATHLEEN M. RAVIELE, MD PC

Practice address

2799 Lawrenceville Hwy
Suite 110
Decatur, GA 30033-2517

Phone

(770) 491-0255

Fax

(770) 491-8157

NPI assigned

Sep 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carol H Garrison

Title

Insurance

Phone

(770) 491-0255

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1316296411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2799 LAWRENCEVILLE HWY",
            "address_2": "SUITE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332517",
            "telephone_number": "770-491-0255",
            "fax_number": "770-491-8157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 LAWRENCEVILLE HWY",
            "address_2": "SUITE 110",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332517",
            "telephone_number": "770-491-0255",
            "fax_number": "770-491-8157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN M. RAVIELE, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "GARRISON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "INSURANCE",
        "authorized_official_telephone_number": "770-491-0255"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "020801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000179935C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "16BDCCB",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Joseph Kashey Jr., LMSW
• Ali Kashkouli, M.D.
• Robert F Kassatly, PAA
• Kate Christman, LCSW LLC
• Alecia Rebecca Kates, RN
• Katie Leikam, LLC
• Greg Kato
• Carolyne N Katongole, FNP
• David E Katz, M.D.
• Ian Katz, M.D.

• Gynecology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.